Florida is asking the federal government to cap its funding to the state’s Medicaid program. Florida Gov. Rick Scott and Republican lawmakers say that will mean more flexibility to provide quality healthcare at an affordable cost. But critics point to welfare reform and say fewer people will get health care.
The Center on Budget and Policy Priorities said poor families in Florida and across the U.S. are poorer now than they were in 1996. That’s the year Congress changed cash assistance to low-income families, or welfare, to a block grant system. Former President Bill Clinton enacted the changes in 1996.
“When I ran for president four years ago, I pledged to end welfare as we know it," Clinton said. "I have worked very hard for four years to do just that.”
Congress is currently considering making Medicaid into block grants. That means capping the federal dollars to states, but allowing states greater freedom to limit eligibility or services Or impose requirements like working a certain number of hours a week. Florida Agency for Health Care Administration Secretary Justin Senior said the state can provide the best Medicaid service without cutting anyone from its rolls. Health policy advocates have said treating Medicaid like welfare will leave Floridians without medical care and hurt seniors in nursing homes.
Clinton created Temporary Assistance For Needy Families, also known as TANF, more than 20 years ago. States impose time limits, penalties and lifetime caps on benefits.
Karen Woodall is with the Florida Center for Fiscal and Economic Policy. She said less people are on TANF because they don’t meet the state imposed requirements.
“Most studies show that there’s not a correlation between people leaving the program and having jobs that lifted them out of poverty,” she said.
Florida gives a TANF family of three a max of $303 a month. Florida has not increased its monthly benefit or kept up with inflation since TANF was created. It’s one of 16 states where benefits are 20 percent below the federal poverty line.
Scott said he wants Florida’s entire $26 billion Medicaid budget to be block granted. The state gets nearly 16 billion in federal funding and taxpayer funds and other state money makes up the rest.
“So, my goal is to get a lot more flexibility from the federal government because no different from Florida, I’m sure every governor believes they know what’s best for their citizens and I believe we can build a better program if the federal government gives us the money without all the strings attached,” he said.
The state of Florida is asking President Donald Trump’s administration for more flexibility to set eligibility standards and to start coverage when patients are approved for Medicaid and not when they applied, which is currently the policy. The application process can take months.
Lu Marie Polivka West, a research associate with the Claude Pepper Center, said taking that retroactive coverage away will be a huge financial burden.
“The individuals and their families would be responsible for that and they don’t have the funding, they’re not going to be able to stay in the nursing home," she said. "Because nonpayment of care is one of the allowed reasons for a person to be discharged.”
Scott is asking the feds to waive a law that regulates provider rates and to waive requirements for Florida to consider public comments. Senior said the changes will save the state $830 million.